Pennsylvania Military Museum Living Historian Form

Pennsylvania Military Museum Living Historian Form

LIVING HISTORIAN FORM

Welcome to the Living History Program at the Pennsylvania Military Museum! Thank you for your interest in participating in our educational programming. If you are attending multiple events this year, please resubmit this form for each living history weekend. By filling in the information below, we will be able to better serve you while on-site. Museum events are invite-only. Thanks!
- Full Name:
  
  First NameLast Name
- Address:
  
  Street Address
  
  Street Address (Cont'd)
  
  CityState
  
  Zip Code
- Phone Number:
  Please enter a valid phone number.Format: (000) 000-0000.
- Email:
  Please enter a valid email address.
- Full Name:
  
  First NameLast Name
- Relationship:
  Ex: Parent
- Primary Phone:
  Please enter a valid phone number.Format: (000) 000-0000.
- Secondary Phone:
  Please enter a valid phone number.Format: (000) 000-0000.
- Logistics & Impressions
- Have you volunteered with the museum before?
- What living history weekend are you currently registering for? Select one per form.
- What unit are you portraying while at this encampment?
  Ex: 4th Infantry Division
- Are you a member of a group? What is its name?
  Ex: The Furious Fourth WWII Living History Association
- What is the name of your organization's leader?
  Ex: John Smith
- The goal of the Pennsylvania Military Museum is to accurately represent and honor the memory of those who served in America’s Armed Forces. All clothing, weapons, and equipment should be of the era or reproduced with the same materials in the same style and fit. Participants in the Living History Program must abide to these authenticity standards. After a registration form is submitted, the site will review impressions for consideration and feedback. Participants will then receive an email once their impression has been approved or rejected. If approved, this email serves as an official invite. The Pennsylvania Military Museum’s goal is to welcome all participants while ensuring a level of authenticity and providing opportunity for professionalization. The museum reserves the right to: (1) inform participants of inaccurate components, (2) ask participants to make corrections to their impression, and (3) if individuals do not adhere to such requirements, dismiss the participant from the event. If you are new to the hobby or an impression, please contact educator Mark Frederick at fredm@pa.gov. Thank you for your dedication to historical accuracy!
- Upload one photo of your impression for review.
  
  UPLOAD FULL-BODY PORTRAITS ONLY. JPEG files preferred.
  Cancelof
- When will you be on-site?
- Which day(s) are you camping overnight?
- Are you pitching a tent?
- Weapons & Transportation
- How many historic weapons will you have at the event?
- Describe your weapon(s), including type and model.
  Ex: M1A1 Thompson Submachine Gun, Semi-Auto
- Is your weapon registered with your organization?
- Can you participate in any weapon demonstrations?
- Review the Safety Manual for Historic Weapons Programs.
- Safety Manual Agreement:
- Are you bringing a horse or mule in an equine trailer?
- Are you bringing a historic vehicle for public display?
- Food & Health
- Which days do you want a complimentary meal?
- Please list food allergies.
  Ex: Wheat, Nuts, Milk, Eggs, etc.
- Please list other allergies.
  Ex: Penicillin, Latex, Insects, etc.
- Please inform us of any other health conditions you have.
  Ex: Diabetes, Mobility Issues, etc.
- I, the undersigned, do hereby acknowledge as a participant in this event at the Pennsylvania Military Museum, that I freely and voluntarily engage in a hazardous activity for my own recreation, and for the benefit of providing a living history example to the public in attendance. I recognize that as part of this event, myself and others will traverse possibly dangerous terrain and obstacles and transport and care for and use various firearms and weapons. I freely assume any and all risk of injury while participating as a volunteer in the specified event. For these reasons, I hereby waive and release from liability and agree to hold harmless the following:
  
  (1) The Commonwealth of Pennsylvania elected officials, including the staff of the Pennsylvania Historical and Museum Commission and Pennsylvania Military Museum; and
  
  (2) The Friends of the Pennsylvania Military Museum, its Board of Directors, its officers, its staff, its volunteers, and its membership-at-large; and
  
  (3) All owners and operators of participating vehicles, both modern and vintage, that may be used to transport supplies, equipment, and personnel on or about the property
  
  (4) For any and all damages of any kind or nature to my person and property arising out of or resulting from my direct or indirect participation in this event
  
  (5) Furthermore, I grant permission for the PHMC to use any type of photographic image or sound recordings made of me for the purposes of education, marketing, or advertising
  
  I certify that I am over 18 years of age and have received, read, understand, and agree to adhere to the PHMC Safety Manual for Historic Weapons demonstrations. I further state that I have fully read and understood the contents of this liability statement and that I am voluntarily waiving rights that may be granted to me by Federal, State, and Local statues, as well as the common law of the nation.
- Participant Verification:
- Participant Signature:
- Parent/Guardian Signature:
  Only if the participant is under the age of 18.
- Date Completed:
  
  MonthDayYear
- Human Verification:
- On-Site Use Only
- Participant Signature:
  Sign Here
- Weapon Check:
- Ammo Check:
- Safety Officer Signature:
  Sign Here
- Reason for Failure:
  Explain Here
- Weapon Re-Check:
- Ammo Re-Check:
- Safety Officer Signature:
  Sign Here
- Should be Empty: